Inconsistency of AI in intracranial aneurysm detection with varying dose and image reconstruction.
Authors
Affiliations (6)
Affiliations (6)
- Department of Radiology and Neuroradiology, Unfallkrankenhaus Berlin, Warener Str. 7, 12683, Berlin, Germany.
- Department of Diagnostic Radiology and Neuroradiology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
- Department of Neuroradiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
- Department of Radiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany. [email protected].
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany. [email protected].
Abstract
Scanner-related changes in data quality are common in medical imaging, yet monitoring their impact on diagnostic AI performance remains challenging. In this study, we performed standardized consistency testing of an FDA-cleared and CE-marked AI for triage and notification of intracranial aneurysms across changes in image data quality caused by dose and image reconstruction. Our assessment was based on repeated examinations of a head CT phantom designed for AI evaluation, replicating a patient with three intracranial aneurysms in the anterior, middle and posterior circulation. We show that the AI maintains stable performance within the medium dose range but produces inconsistent results at reduced dose and, unexpectedly, at higher dose when filtered back projection is used. Data quality standards required for AI are stricter than those for neuroradiologists, who report higher aneurysm visibility rates and experience performance degradation only at substantially lower doses, with no decline at higher doses.